crossing96/oncoscreening huggingface dataset:
Cytomorphologic features of metastatic urothelial carcinoma in serous effusions.	"Metastatic urothelial carcinoma (UC) to serous effusion (SE) is extremely rare and its cytomorphological features have only been described in case reports. In this study, we searched the pathology database at University of Michigan for SEs due to metastatic UC in the last 20 years. A total of 25 cases from 20 patients with clinically and pathologically confirmed metastatic UC in SEs were retrieved. The specimens consisted of 15 pleural, 8 peritoneal, and 2 pericardial effusions. Smears were reviewed and evaluated for the following features: cellularity, single cells, cell clusters or short cords, cell wrapping, ""windows"" between the cells, two-tone cytoplasm, cytoplasmic vacuoles, signet ring cells, nuclear to cytoplasmic (N/C) ratio, nuclear hyperchromasia, irregular nuclear membrane, nuclear centricity, double or multiple nuclei, nucleoli, anaplastic cells and mitosis. Our results showed that UC manifested in SEs predominantly as a single cell population with or without clusters or short cords, and frequently exhibited the ""cell wrapping"" of two or more cells. Individual UC cell in SEs exhibited nuclear enlargement with increased N/C ratio, irregular nuclear membranes, hyperchromatic coarse chromatin and frequently prominent nucleoli. Double or multinucleated cells, cells with vacuolated cytoplasm or signet ring appearance were also frequently present. Our results demonstrated that while certain features could suggest the diagnosis of UC, the cytomorphological features are not specific and often overlap with those of reactive mesothelium, mesothelioma, metastatic adenocarcinoma, or squamous cell carcinoma in SEs. Accurate diagnosis of UC rests on the combination of clinical history, cytomorphologic features and appropriate immunohistochemical panel."	bladder
Feasibility of radical cystectomy in exclusive spinal and/or epidural anaesthesia.	PURPOSE: Muscle invasive bladder cancer can be found predominantly in elderly people with a high likelihood of suffering from concomitant diseases; especially in these patients, the risks associated with general anaesthesia during radical cystectomy can be the limiting factor of performing an otherwise indicated radical operation. To overcome this limitation, we analysed the feasibility of performing radical cystectomy in exclusive spinal and/or epidural anaesthesia. METHODS: Between March and June 2010, nine patients underwent radical cystectomy in exclusive spinal and/or epidural anaesthesia. These patients were either not willing or unfit to undergo radical cystectomy in general anaesthesia. A continent urinary diversion (ileum neobladder) and an ileum-conduit were performed in five patients and four patients, respectively. The feasibility of radical cystectomy in regional anaesthesia was tested using a variety of parameters. RESULTS: All nine procedures could be performed under strict regional anaesthesia. Mean operation time was 206 min (range 146-265 min), mean intraoperative blood loss was 622 ml (range 200-1,500 ml), mean postoperative time at intermediate care was 1 day (range 0-3 days) and mean length of hospital stay was 21.8 days (range 17-26 days). Analgesics of the WHO class I, II and III were applied for 5.7, 1.2 and 2.8 days mean, respectively. CONCLUSION: Performance of radical cystectomy in exclusive spinal and/or epidural anaesthesia is feasible and can be considered particularly in those patients who would be otherwise unfit to undergo radical cystectomy in general anaesthesia. This new operative and anaesthesiological concept could also play an important role in new fast track regimens.	bladder
Increased risk of bladder cancer following diagnosis with bladder pain syndrome/interstitial cystitis.	AIMS: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a prevalent disorder that may contribute to bladder cancer (BC). This cohort study set out to investigate the association between IC/BPS and BC by using a population-based dataset. METHODS: The data for this study were sourced from the Taiwan National Health Insurance program. The case cohort comprised 7,562 patients with IC/BPS, and 22,686 randomly selected subjects were used as a comparison cohort. A Cox proportional hazards regression model (stratified by age group, geographic location, urbanization level, and the index year) was constructed to estimate the risk of subsequent BC following a diagnosis of IC/BPS. We also ran the analysis utilizing an alternative comparison cohort composed of patients with urinary incontinence (UI). RESULTS: In the study sample of 30,248 patients, 96 patients (0.32%) received a diagnosis of BC during the 3-year follow-up period; 48 (0.63% of patients with IC/BPS) were from the study cohort; and 48 (0.21% of patients without IC/BPS) were from the comparison cohort. The incidence rate of BC was 2.12 (95% CI: 1.58-2.78) per 1,000 person-years in patients with IC/BPS and 0.70 (95% CI: 0.52-0.92) per 1,000 person-years in comparison patients. Cox proportional analysis revealed that the adjusted HR for BC during the 3-year follow-up period for patients with IC/BPS was 2.95 (95% CI: 1.97-4.41) that of comparison subjects. When performing the analysis with the alternative UI comparison cohort, the adjusted HR for BC was 1.96 (95% CI: 1.14-3.39). CONCLUSIONS: This investigation detected a novel association between BC and prior IC/BPS.	bladder
A dosimetric comparison of 3D conformal vs intensity modulated vs volumetric arc radiation therapy for muscle invasive bladder cancer.	BACKGROUND: To compare 3 Dimensional Conformal radiotherapy (3D-CRT) with Intensity Modulated Radiotherapy (IMRT) with Volumetric-Modulated Arc Therapy (VMAT) for bladder cancer. METHODS: Radiotherapy plans for 15 patients with T2-T4N0M0 bladder cancer were prospectively developed for 3-DCRT, IMRT and VMAT using Varian Eclipse planning system. The same radiation therapist carried out all planning and the same clinical dosimetric constraints were used. 10 of the patients with well localised tumours had a simultaneous infield boost (SIB) of the primary tumour planned for both IMRT and VMAT. Tumour control probabilities and normal tissue complication probabilities were calculated. RESULTS: Mean planning time for 3D-CRT, IMRT and VMAT was 30.0, 49.3, and 141.0 minutes respectively. The mean PTV conformity (CI) index for 3D-CRT was 1.32, for IMRT 1.05, and for VMAT 1.05. The PTV Homogeneity (HI) index was 0.080 for 3D-CRT, 0.073 for IMRT and 0.086 for VMAT. Tumour control and normal tissue complication probabilities were similar for 3D-CRT, IMRT and VMAT. The mean monitor units were 267 (range 250-293) for 3D-CRT; 824 (range 641-1083) for IMRT; and 403 (range 333-489) for VMAT (P < 0.05). Average treatment delivery time were 2:25min (range 2:01-3:09) for 3D-CRT; 4:39 (range 3:41-6:40) for IMRT; and 1:14 (range 1:13-1:14) for VMAT. In selected patients, the SIB did not result in a higher dose to small bowel or rectum. CONCLUSIONS: VMAT is associated with similar dosimetric advantages as IMRT over 3D-CRT for muscle invasive bladder cancer. VMAT is associated with faster delivery times and less number of mean monitor units than IMRT. SIB is feasible in selected patients with localized tumours.	bladder
[Acute arthritis secondary to intravesical bacillus Calmette-Guérin for bladder cancer].	INTRODUCTION: We sought to identify the prevalence, presentation, treatment, and prognosis of acute arthritis secondary to intravesical bacilli Calmette-Guérin (BCG) therapy for bladder cancer. METHODS: We performed a structured, systematic review of the English language literature pertaining to BCG and reactive arthritis among bladder cancer patients. We extracted data pertaining to prevalence, presentation, management, and prognosis. RESULTS: We extracted 23 individual case reports and 4 review articles. Thirty-nine patients -31 (80%) male and 8 (20%) female- were described in these publications; we also identified 1 patient from our institution. Although prevalence estimates of reactive arthritis range from 0.5 to 1.0% of all bladder cancer patients receiving BCG, the true prevalence remains unclear. Polyarthritis (68%) and fever (58%) were the most common presenting symptoms. Among patients presenting with joint pain, the knees (41%), ankles (26%), and wrists (19%) were most often affected. The most common time of presentation was immediately following the 4th instillation of a 6-week induction course (25%). Initial therapy in 100% of patients was discontinuation of BCG. Other therapies included nonsteroidal anti-inflammatory drugs (NSAIDs) (25%); steroids (8%); anti-tubercular medications (8%); and combined NSAIDs, steroids, and anti-tubercular medications (20%). CONCLUSIONS: Reactive arthritis is an infrequent but potentially severe complication of intravesical BCG for bladder cancer that typically presents with polyarthritis and fever during induction. The most common treatments include immediate discontinuation of BCG and systemic anti-inflammatory therapy. Further studies are needed to determine prevalence, pathophysiology, and long-term prognosis.	bladder
[Laparoscopic radical cystectomy with extended pelvic lymph node dissection for bladder urothelial carcinoma: complications and oncologic outcomes in 210 cases].	OBJECTIVE: To investigate the complications and oncologic outcomes of 210 cases of bladder urothelial carcinoma (BUC) treated with laparoscopic radical cystectomy (LRC) with extended pelvic lymph node dissection (EPLND) and assess the feasibility and safety of this surgical technique. METHODS: From January, 2003 to March 2010, 210 patients with BUC underwent LRC with EPLND. The cases with positive lymph nodes or T3a disease received adjuvant chemotherapy after the operation. The complications and oncologic results were recorded and analyzed. RESULTS: The mean operative time was 105 min in these cases with a mean blood loss of 220 ml and a rate of perioperative blood transfusion of 20.5%. The mean number of harvested lymph nodes was 17.6, and 42 (20%) cases were found to have positive lymph nodes. Minor and major perioperative complications occurred in 19% and 5.3% of the cases, respectively. The 5-year estimated overall survival, cancer-specific survival, recurrence-free survival and metastasis-free survival rates were 73.8%, 83.3%, 81.8% and 90.5%, respectively. CONCLUSIONS: LRC with EPLND is a safe and feasible technique for management of BUC and can produce satisfactory oncologic results.	bladder
Can pretreatment ADC values predict recurrence of bladder cancer after transurethral resection?	OBJECTIVE: The aim of this retrospective study was to investigate the association between the pretreatment apparent diffusion coefficient (ADC) value and recurrence of bladder cancer after transurethral resection. METHODS: Patients with superficial bladder cancer were identified. Mean ADC values of the tumors were compared between patients with and without recurrence following trans-urethral resection. A receiver-operator characteristic curve was used for determining the optimal cutoff ADC value. Univariate and multivariate analyses were used to determine the effect of ADC values and other factors. RESULTS: With a mean follow-up period of 25 months, bladder cancer recurred in 14 of 44 patients (32%). The mean ADC value of tumors in patients with recurrence was lower than in those without recurrence (1.08 mm2/s vs. 1.28×10(-3) mm2/s; p=0.003). The optimal cutoff ADC value for predicting recurrence was determined to be 1.12×10(-3) mm2/s. A modest and significant negative correlation was observed between the ADC values and tumor size (r=-0.436, p=0.008). After adjustment for size and risk groups, an ADC value equal to or less than the optimal cutoff remained a significant predictor of recurrence (odds ratio 6.3, 95% CI 1.23-32.2, p=0.027). CONCLUSION: Pretreatment ADC values may be an independent predictor of bladder cancer recurrence.	bladder
Genome-wide CNV analysis replicates the association between GSTM1 deletion and bladder cancer: a support for using continuous measurement from SNP-array data.	BACKGROUND: Structural variations such as copy number variants (CNV) influence the expression of different phenotypic traits. Algorithms to identify CNVs through SNP-array platforms are available. The ability to evaluate well-characterized CNVs such as GSTM1 (1p13.3) deletion provides an important opportunity to assess their performance. RESULTS: 773 cases and 759 controls from the SBC/EPICURO Study were genotyped in the GSTM1 region using TaqMan, Multiplex Ligation-dependent Probe Amplification (MLPA), and Illumina Infinium 1 M SNP-array platforms. CNV callings provided by TaqMan and MLPA were highly concordant and replicated the association between GSTM1 and bladder cancer. This was not the case when CNVs were called using Illumina 1 M data through available algorithms since no deletion was detected across the study samples. In contrast, when the Log R Ratio (LRR) was used as a continuous measure for the 5 probes contained in this locus, we were able to detect their association with bladder cancer using simple regression models or more sophisticated methods such as the ones implemented in the CNVtools package. CONCLUSIONS: This study highlights an important limitation in the CNV calling from SNP-array data in regions of common aberrations and suggests that there may be added advantage for using LRR as a continuous measure in association tests rather than relying on calling algorithms.	bladder
Hedgehog signaling regulates bladder cancer growth and tumorigenicity.	The role of Hedgehog (HH) signaling in bladder cancer remains controversial. The gene encoding the HH receptor and negative regulator PATCHED1 (PTCH1) resides on a region of chromosome 9q, one copy of which is frequently lost in bladder cancer. Inconsistent with PTCH1 functioning as a classic tumor suppressor gene, loss-of-function mutations in the remaining copy of PTCH1 are not commonly found. Here, we provide direct evidence for a critical role of HH signaling in bladder carcinogenesis. We show that transformed human urothelial cells and many urothelial carcinoma cell lines exhibit constitutive HH signaling, which is required for their growth and tumorigenic properties. Surprisingly, rather than originating from loss of PTCH1, the constitutive HH activity observed in urothelial carcinoma cell lines was HH ligand dependent. Consistent with this finding, increased levels of HH and the HH target gene product GLI1 were found in resected human primary bladder tumors. Furthermore, on the basis of the difference in intrinsic HH dependence of urothelial carcinoma cell lines, a gene expression signature was identified that correlated with bladder cancer progression. Our findings therefore indicate that therapeutic targeting of the HH signaling pathway may be beneficial in the clinical management of bladder cancer.	bladder
Classification of samples into two or more ordered populations with application to a cancer trial.	In many applications, especially in cancer treatment and diagnosis, investigators are interested in classifying patients into various diagnosis groups on the basis of molecular data such as gene expression or proteomic data. Often, some of the diagnosis groups are known to be related to higher or lower values of some of the predictors. The standard methods of classifying patients into various groups do not take into account the underlying order. This could potentially result in high misclassification rates, especially when the number of groups is larger than two. In this article, we develop classification procedures that exploit the underlying order among the mean values of the predictor variables and the diagnostic groups by using ideas from order-restricted inference. We generalize the existing methodology on discrimination under restrictions and provide empirical evidence to demonstrate that the proposed methodology improves over the existing unrestricted methodology. The proposed methodology is applied to a bladder cancer data set where the researchers are interested in classifying patients into various groups.	bladder
Indication and timing of cystectomy in high-risk bladder cancer.	PURPOSE OF REVIEW: Although the conservative approach including Bacillus Calmette-Guerin (BCG) therapy is considered as the first-line option in high-risk nonmuscle invasive bladder tumors, cystectomy is often required as an alternative treatment in the case of BCG failure. Considering all the parameters, including clinical data, endoscopic aspects and new biological markers, the question of the indication, and moreover timing, of cystectomy has become crucial. RECENT FINDINGS: In fact, the real positive effect of BCG remains controversial and its actual benefit in terms of survival is not evident. Therefore, early cystectomy for this population with high risk of progression and metastasis diffusion is clearly a radical approach which can lead to a reduction in specific mortality. Recent articles have studied the parameters involved in this issue to determine the exact timing of cystectomy. SUMMARY: To avoid delay of appropriate treatment, it is crucial to determine the non-BCG responder population. Unfortunately, no consensual marker is currently available. Nevertheless, multifocal tumors, associated carcinoma in situ, prostatic urethral involvement, tumoral size greater than 3 cm and depth of infiltration are useful parameters in clinical practice to propose early cystectomy. In the future, the crucial question of cystectomy timing may be answered by progress in molecular signatures for bladder cancers.	bladder
Inflammatory pathways as promising targets to increase chemotherapy response in bladder cancer.	While more and more physicians are choosing chemotherapy for patients with bladder cancer, the current treatment is still far from satisfactory due to low response rate and severe side effects. Emerging evidence indicates that inflammatory microenvironment is involved in the pathogenesis of bladder cancer. Recent studies have also provided ample evidence that chemotherapy response is influenced by activation of major inflammatory mediators, including transcription factors, cytokines, chemokines, and COX-2. We reviewed all published literature addressing the roles of inflammatory microenvironment in bladder cancer and evaluating emerging evidence that inflammatory pathways represent potential therapeutic targets to enhance chemotherapy of bladder cancer.	bladder
Influence of age on false positive rates of urine-based tumor markers.	INTRODUCTION: Several influencing factors on false positive rates (FPRs) of urine-based tumor markers in the detection of urothelial cancer (UC) have been identified. We evaluated age as a possible influencing factor. METHODS: Urinary cytology (Cyt), UroVysion (FISH), ImmunoCyt (uCyt+) and NMP22 were determined in 1,554 patients suspicious for UC of the bladder before cystoscopy and in case of cancer detection before TURB. Additionally, upper urinary tract imaging was performed. Maker sensitivity, specificity and FPRs were evaluated in the entire cohort and in subgroups divided by age into <50, ≥ 50-70 and ≥ 70 years. Contingency tables and the Cochrane Armitage tests were used for statistical comparisons. RESULTS: UC was found in 377 and no UC in 1,177 (75 %) patients. A total of 336 patients were diagnosed with UC of the bladder and 41 with UC of the upper urinary tract. Overall sensitivity and specificity for Cyt were 82 and 82 %: for FISH, 73 and 79 % and for uCyt+, 79 and 75 %, respectively. For NMP22, regardless of the exclusion criteria they were 72 and 34 % and after exclusion of urinary tract infection (UTI) or prior to manipulation 46 and 86 %, respectively. Significantly higher FPRs were found with increasing age for Cyt (p = 0.001), a trend to higher FPRs for uCyt+ (p = 0.11) and almost no difference for FISH (p = 0.63). For NMP22, differences became significant after exclusion of patients with UTI or prior manipulation (p = 0.02). CONCLUSIONS: The results of the present study give evidence that false positive rates of Cyt and NMP22 increase with age indicating that age should be respected for their correct interpretation.	bladder
Synchronous primary cancers of urinary bladder and kidney and prostate.	Synchronous occurrence of two or more than two primary cancers of the urinary tract is quite rare, and poses a difficult treatment challenge. Here, we present a case of synchronous renal cell carcinoma, transitional cell carcinoma of urinary bladder and adenocarcinoma of prostate diagnosed within a short period. To the best of our knowledge, this is the first case reported from India and the youngest patient reported in the literature having this combination of urinary cancers.	bladder
Enhanced stability of microRNA expression facilitates classification of FFPE tumour samples exhibiting near total mRNA degradation.	BACKGROUND: As degradation of formalin-fixed paraffin-embedded (FFPE) samples limits the ability to profile mRNA expression, we explored factors predicting the success of mRNA expression profiling of FFPE material and investigated an approach to overcome the limitation. METHODS: Bladder (n=140, stored 3-8 years) and cervix (n=160, stored 8-23 years) carcinoma FFPE samples were hybridised to Affymetrix Exon 1.0ST arrays. Percentage detection above background (%DABG) measured technical success. Biological signal was assessed by distinguishing cervix squamous cell carcinoma (SCC) and adenocarcinoma (AC) using a gene signature. As miR-205 had been identified as a marker of SCC, precursor mir-205 was measured by Exon array and mature miR-205 by qRT-PCR. Genome-wide microRNA (miRNA) expression (Affymetrix miRNA v2.0 arrays) was compared in eight newer FFPE samples with biological signal and eight older samples without. RESULTS: RNA quality controls (QCs) (e.g., RNA integrity (RIN) number) failed to predict profiling success, but sample age correlated with %DABG in bladder (R=-0.30, P<0.01) and cervix (R=-0.69, P<0.01). Biological signal was lost in older samples and neither a signature nor precursor mir-205 separated samples by histology. miR-205 qRT-PCR discriminated SCC from AC, validated by miRNA profiling (26-fold higher in SCC; P=1.10 × 10(-5)). Genome-wide miRNA (R=0.95) and small nucleolar RNA (R=0.97) expression correlated well in the eight newer vs older FFPE samples and better than mRNA expression (R=0.72). CONCLUSION: Sample age is the best predictor of successful mRNA profiling of FFPE material, and miRNA profiling overcomes the limitation of age and copes well with older samples.	bladder
KRAS mutation is present in a small subset of primary urinary bladder adenocarcinomas.	AIMS: To determine whether KRAS mutations occur in primary bladder adenocarcinoma. METHODS AND RESULTS: Twenty-six cases of primary urinary bladder adenocarcinoma were analysed. DNA was extracted from formalin-fixed, paraffin-embedded tissue and amplified with shifted termination assay technology, which recognizes wild-type or mutant target sequences and selectively extends detection primers with labelled nucleotides. A mutation in KRAS was found in three (11.5%) of 26 primary bladder adenocarcinomas. Two of these three cases exhibited a G13D mutation, whereas the remaining case contained a mutation in G12V. None of the ten cases of urothelial carcinoma with glandular differentiation displayed KRAS mutation. Colonic adenocarcinoma contained a KRAS mutation in 18 (33%) of 55 cases. There was no distinct difference with regard to grade, stage or outcome according to the limited clinicopathological data available. However, the two youngest patients, aged 32 and 39 years, in our study group, with a mean population age of 61 years, were found to have mutations in KRAS. CONCLUSIONS: KRAS mutations are present in a small subset of primary urinary bladder adenocarcinomas. Future clinical trials for treatment of bladder adenocarcinoma, employing targeted therapies similar to those used for treatment of colon cancer, may also benefit from the predictive implications of KRAS mutational testing.	bladder